Case Study

15_00223 Norman B DCM or unclassified cardiomyopathy–NEED CAPTIONS—

A neutered male, 13 year old DSH weighing 15.6 lbs was presented for evaluation of pleural effusion. The patient was started on Lasix.

Sonographic Differential Diagnosis

DCM or unclassified cardiomyopathy. Poor long term prognosis. Triple thrapy with Lasix at 2-3 mg/kg b.i.d., ace inhibitor at 0.5 mg/kg s.i.d. and off label Pimobendan at 0.25 mg/kg b.i.d. would be recommended. Plavix therapy should also be considered. A recheck echocardiogram is recommended in 1-2 weeks. This patient is at high risk for sudden death. Very guarded to long term prognosis. Taurine supplementation is recommended as well as examination of the diet for potential lack of taurine. Blood pressure measurements and renal values should be monitored carefully as well as chest radiographs over the next week.

Image Interpretation

The cardiac presentation in this patient presented severe volume overload in the left and right heart with tachyarrhythmia. Severe hypocontractility was noted. This is consistent with dilated cardiomyopathy. Septal and free wall thicknesses were normal. Right atrial enlargement was also noted and measured 1.8 cm. Tricuspid insufficiency was present and velocity measured 2.6 m/sec. Pulmonary and aortic outflow velocities were subnormal owing to systolic dysfunction. Pleural effusion was noted. EPSS 0.41.